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Wounded warriors battle a set of challenges

Modern medicine has helped achieve the highest combat survival rate in recorded history, but that means more wounded warriors now need help getting a job and health care.

“We are routinely saving on the battlefield folks that in any other war would have died,” said Rear Adm. C. Forrest Faison III, commander of Navy Medicine West and commander of Naval Medical Center San Diego (Balboa).

He spoke on Wednesday at the San Diego Military Advisory Council’s monthly breakfast inside the Naval Mine and Anti-Submarine Warfare Command on Harbor Drive.

About 97 percent of wounded warriors cared for in San Diego won’t return to active duty, Faison said. They are, on average, in their early 20s.

“They have their entire lives ahead of them,” he said. “What are things we need to do to be able to care for them?”

It’s easier said than done. The national strategy for taking care of wounded warriors and their families remains unclear, as does the role the government should play.

Their future can be brighter by addressing four critical areas: comprehensive health care, educational services, job and career transition, and family support.

One of the main challenges lies in distributing health care resources.

“We’ve sunk hundreds of millions of dollars into caring for these folks, but we need to figure out ease of access," Faison said.

San Diego, says Faison, offers phenomenal and seamless health care when it comes to collaborating between the Department of Defense, Veterans Affairs and local hospital systems.

“That’s not so true in other areas of the country,” he said.

He told a story of one wounded warrior who wanted to return to his hometown in the Midwest, 300 miles from the closest VA.

Initially, it seemed like a story with a happy ending. The Silver Star recipient -- the third highest military decoration for valor -- had a house and job lined up.

A month later, his job had fallen through and his house was not in compliance with the Americans with Disabilities Act, so he couldn’t use it.

“The town assured us there was a good doctor there with a lot of experience in prosthetic care,” Faison said.

That doctor turned out to be a 75-year-old general practitioner who had never seen an amputation.

“Basically, he was flipping burgers at McDonalds,” Faison said. “We sent a plane out, picked him up and brought him back. He’s here now, and we are transitioning him in San Diego.”

One challenge in health care distribution lies in the fact there are only seven schools in the United States that train prosthetists.

There aren't enough mental health facilities, either. The Department of Health and Human Services spotted nearly 3,700 areas in the United States with insufficient mental health services to meet the needs of the 90.3 million people living there.

For wounded warriors who are dealing with traumatic brain injuries and mental health issues, Naval Medical Center San Diego has come up with a unique treatment option.

It's handing out iPad 2s to wounded warriors in hopes they might offer a two-fold effect: aid in short-term memory loss and potentially prevent suicide.

Between state tuition benefits and discounts, the government and communities have made it easier and more affordable than ever to get an advanced college degree. Yet only up to 30 percent of wounded warriors are attending college, and of those who do, up to 88 percent drop out after the first year.

The reason, Faison explained, is due to traumatic brain injury, which comes with short-term memory loss.

“I couldn’t have gotten through college without my short-term memory. Cramming the night before,” he said.

The problem is that adaptive technologies for short-term memory loss are geared toward Alzheimer’s patients -- not young wounded warriors.

“That’s not so good if you are 21 years old and got a date and need to figure out how to get to and from the movies and restaurant,” Faison said.

Balboa is partnering with the community to develop GPS apps to help these veterans get to and from locations, as well as academic apps to help them with memory and college courses.

“It’s mobile, it’s socially acceptable to that age group, and people can use it as an adaptive technology for short-term memory,” Faison said.

Faison is also looking to see if the iPad 2s could play a part in preventing suicides.

“Many of these folks have gone through life-changing events or have [post-traumatic stress disorder]. Suicide is a concern,” he said. “You are 20 years old and it’s 2 a.m. and you are thinking about doing something like that. What are your options?”

One is to go to the emergency room to talk to a doctor they’ve never met; swallow their pride and ask a buddy for help; call a help line and talk to a stranger; or get drunk and hope it goes away.

“None of those are good options. What if using that camera on an iPad 2 you can Skype to your doctor, asking for advice and meet him in a private place,” he said. “That might be a way to combat suicide. We are checking it out.”

San Diego has the largest-growing population of veterans in the country returning from Iraq and Afghanistan.

“Employers here want to hire folks. That has been an attraction and draw for more vets coming here than anywhere else in the country -- and that includes wounded warriors,” Faison said.

Despite there being no shortage of companies that want to hire veterans, an unemployment problem remains in San Diego.

Veterans Village, a local nonprofit that cares for homeless veterans, saw a 15-fold increase among those returning from Iraq and Afghanistan from 2010 to 2011.

“That number is concerning,” Faison said. “Despite living in the probably most military friendly, supported community in the nation, we are still seeing challenges in this area.”

In last year’s testimony to the House Armed Services Committee, former chairman of the Joint Chiefs of Staff Marine Gen. Peter Pace said the jobless rate among wounded warriors might exceed 40 percent.

The obstacle, he said, is building a network of job leads and better connecting hiring employers with veterans on the job market.

“What one single number can you call to offer up a job?” he asked. “How do all these efforts come together in a united front?”

He offered up a solution that might be able to solve across-the-board challenges among wounded warriors and their families: Provide a one-stop shop.

The concept, named Invictus San Diego, is currently in the works. The single facility would complement services provided at Balboa, the VA, local hospitals and other providers throughout the county.

“What if we could take all those services that wounded warriors need -- medical care from us and the DoD and corporate partners, college services, job and career transition and family support, including child care, and bring that into one location in the community?" he said.

As the wounded warrior population stabilizes and capacity is created at the center, it can treat others in the community.

“The mom who lost a foot from uncontrolled diabetes, can benefit from what we learned in prosthetic care. The high school quarterback who got a concussion in Friday night’s football game can benefit from what we learned in traumatic brain injury,” he said.

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San Diego Military Advisory Council

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San Diego Military Advisory Council Executive(s):

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Larry Blumberg

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